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Treatment decision-making for patients with the Herlitz subtype of junctional epidermolysis bullosa.
[junctional epidermolysis bullosa]
The
Herlitz
subtype
of
junctional
epidermolysis
bullosa
(
JEB-H
)
is
a
lethal
genetic
disorder
characterized
by
recurrent
and
persistent
erosions
of
the
epithelial
surfaces
that
heal
with
exuberant
granulation
tissue
.
In
addition
,
respiratory
distress
,
refractory
anemia
and
failure
to
thrive
are
often
seen
.
Mortality
in
the
first
year
of
life
approaches
90
%
.
JEB-H
is
caused
by
mutations
in
the
genes
that
encode
the
protein
laminin
5
,
a
structural
molecule
involved
in
the
adhesion
of
epidermis
to
dermis
.
There
is
currently
no
cure
for
JEB-H
.
Medical
interventions
treat
complications
but
do
not
ultimately
limit
mortality
.
Ethical
principles
contend
that
offering
comfort
and
company
to
the
patient
and
family
,
not
aggressive
therapies
,
should
comprise
the
mainstay
of
care
for
affected
infants
.
Diseases
Validation
Diseases presenting
"should comprise the mainstay of care for affected infants"
symptom
junctional epidermolysis bullosa
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